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General NPI Number Information
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NPI Number | 1801442975
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Entity Type | Organization
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Legal Business Name | RIVER CITY EDUCATION ORGANIZATION INC
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Dates
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Enumeration Date | 08/14/2019
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Last Update Date | 05/22/2022
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Provider Practice Location Address
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Address Line | 11363 SAN JOSE BLVD STE 200
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City | JACKSONVILLE
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State | FL
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Zip | 32223-7959
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Country | US
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Telephone | 904-337-4090
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Fax |
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Provider Business Mailing Address
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Address Line | 4072 SUNBEAM RD
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City | JACKSONVILLE
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State | FL
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Zip | 32257-8813
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Country | US
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Telephone | 904-425-1725
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALAN HALL
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Credential |
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Telephone | 904-425-1725
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State |
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